Medicine
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Nonsteroidal anti-inflammatory drug-induced small bowel injuries (NSIs) have been largely ignored for decades due to the focus on nonsteroidal anti-inflammatory drug gastropathy. With the visualization of the small intestines enabled by video capsule endoscopy, the frequency and severity of NSIs have become more evident. NSIs have a complex pathophysiology, and no effective preventive or treatment options have been proven. ⋯ Twenty-two studies (3 clinical and 19 in vivo experimental studies) were included in the final analysis involving 10 kinds of CAMs: bovine colostrum, Orengedokuto (coptis), muscovite, licorice, grape seed, wheat, brown seaweed, Ganoderma lucidum fungus mycelia, Chaenomeles speciosa (sweet) Nakai (muguasantie), and Jinghua Weikang capsule. The mechanisms of CAM include an increase in prostaglandin E2, reparation of the enteric nervous system, inhibition of pro-inflammatory cytokines, reduction of intestinal permeability and enteric bacterial numbers, decrease in oxidative stress, and modulation of small intestinal motility. CAM may be a novel alternative option for treating and preventing NSI, and further studies on human and animal models with relevant comorbidities are warranted.
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This study aimed to evaluate the global clinical practice guidelines on fever in children. We also aimed to select a guideline with good methodology and reporting quality to provide scientific reference for diagnosis and treatment of fever in children. ⋯ There are limitations in the methodology and reporting quality of all eight global guidelines on fever in children. For future development of these guidelines, attention should be paid to improving applicability of the guidelines in terms of methodology. Additionally, the principles and explanations for formation of recommendations should be described, as well as the limitations of the reporting guideline in detail in terms of the reporting quality. Treatments of fever in children are similar in different countries, but there are still differences that require further research.
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The stability and longevity of the prosthesis after revision total elbow arthroplasty (TEA) are greatly influenced by the reconstruction of bone defects around the distal humerus and proximal ulna. This study evaluated the clinical and radiological results of reconstruction of a large bone defect using an autogenous fibular strut and iliac bone graft in revision TEA. This retrospective study reviewed 10 patients who underwent revision TEA with autogenous fibular strut and iliac corticocancellous bone graft between March 2007 and May 2016. ⋯ Union of the grafted bone with the distal humerus was achieved at an average of 4.5 months (range, 3-6 months). Re-osteolysis recurred in 2 cases, and additional surgery for bone grafting was performed in 1 case. Autogenous fibular strut bone grafting is an effective technique when revision TEA has large bone defects around the prosthesis resulting in a relatively stable prosthesis fixation and good union rate with a satisfactory clinical outcome after TEA revision.
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Dysphagia is a common complication after stroke. The 2 types of dysphagia with cricopharyngeal dysfunction and swallowing apraxia after stroke are relatively rare and difficult to treat; however, there are few clinical case reports of cricopharyngeal dysfunction and swallowing apraxia after stroke. ⋯ The 2 types of dysphagia with cricopharyngeal dysfunction and swallowing apraxia after stroke are relatively rare and difficult to treat after stroke. Only by improving swallowing apraxia can patients perform mandatory swallowing and balloon dilatation treatment. However, transcranial direct current stimulation has a good therapeutic effect on the primary motor and sensory cortex of the tongue in patients with cricopharyngeal dysfunction and swallowing apraxia.
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Although the research on the risk factors of anterior communicating artery (AComA) aneurysm has made great progress, the independent effect of each risk factor on the rupture of AComA aneurysm is controversial among different studies. We will perform a protocol for systematic review and meta-analysis to investigate risk factors for AComA aneurysm rupture and quantify their independent effects. ⋯ CRD42021284262. (https://www.crd.york.ac.uk/PROSPERO/).